In Reply: We have limited ability to test Dr Pogach's hypothesis that comorbid disorders such as depression contributed to problems in glycemic control and increased costs. But we were able to look at antidepressant prescriptions filled among the 2 cohorts in the baseline year (1992) and the following year. We found that 26% of the improved cohort and 22% of the unimproved cohort received 1 or more prescriptions for an antidepressant during the 2-year period, suggesting no increase in the prevalence of depression in the unimproved group. The evidence that we do have suggests that the improved cohort became less costly despite greater morbidity at baseline, providing support for better glycemic control as an explanation.